Cruising Altitude of Intuition Part 2

And we're back.... at 30,000+ feet, cruising the altitudes of intuition, and praying that listening to my gut sense that this patient could be resilient would prove true.

If you missed the last weekly wave, I am retelling one of the most epic and anxiety invoking stories of my medical career (and existence as a human), traveling on an Airbus A380 from Dubai to Los Angeles.  I suddenly found myself caring for a very ill 6ish year old little girl on board, the language barriers immense between us, which made relying on my physical exam skills, knowledge and what her little body was conveying to me of the utmost importance.

AND I had been asked by the pilot to make a pivotal and swift decision on whether we needed to land in Northern Russia to pursue further care for this little girl (and strand the 300+ passengers on flight because the plane would not be able to take off again), or could we continue on our planned polar route where we very soon would be over the polar ice caps and not be able to land for 10 HOURS! 

So, I ended it my last love letter to you all in the stratospheres of 30,000+ feet letting the captain and crew know that we could continue as planned.

Click here to read the previous blog "Is There A Doctor On Board?" (Part 1!) ......

With a big gulp, lots of prayers, and a ton of internal anxiety I did my best not to outwardly project and remain calm, cool and poised (a skill you definitely cultivate behind the white coat but which rages all the same TBH), we continued.

Not even 5 minutes after this decision was rendered and we continued flying much to the relief of the captain and Emirates crew and with Northern Russia in the rearview mirror, and a sea of polar ice caps ahead and polar bears swimming below, my little patient had two more episodes of emesis (vomiting, remember one of your new medical words?!), and large ones.

She taught me so much that day. As I stated before, my calling to Pediatrics lay in the beauty of the dichotomy and juxtaposition of the extreme vulnerability, and yet resiliency of children.  As vulnerable as she was at the moment, I also called into the universe to manifest its magic and divine intervention like STAT for her resiliency to shine through.

Okay, we're going back into take care of our patient.  Follow me down the aisle and help me care for her. So basically, we had just witnessed her ingesting.  

Cue internal panic.  I'm sweating a little even writing this and challenging myself to recall all of the minor details of that day.  I was in my genius zone and I was suspended in an alternate universe, all at the same time.  Like one of those characters who sees the oasis in the desert- complete with palm trees and some form of lush vegetation and perfectly still blue calm and inviting pool.  I knew we were in a storm at the moment, but that tranquility was possible just up ahead around the corner.  This is much the tempo that we traverse as Pediatricians caring for children. I was picturing us landing and this little patient being transferred in stable condition to LA children's or some facility for pediatrics in the LA county area.

But this wasn't a great start.  I examined her again, writing down all of her vital signs on the document note I was keeping, taking them about every 15 min to track her what I was willing to be progress.  She was able to drink some more.  She wasn't getting any worse.  But we weren't out of the woods yet.... far from it.  

She wanted to lie down on her Mother.  I gave strict instructions to wake her up and have her drink frequently.  I would be back to check on her soon.  I padded my way back to my seat with a lot of people staring at me. Uncomfortable with all the attention, I slinked back into our row and breathed out.  Turned off my TV- movies just weren't appealing anymore.  I was in the middle of a script in which I was one of the key characters, and I just wanted to write my own ending to this unbelievable movie novel I was now co-starring in with this 6ish year old little girl.

I interrupt this scintillating movie to bring you a light hearted infomercial.

So, my husband & and I are in coach which on Emirates Airlines feels super classy.  We've never flown anything but coach, and I gotta say the service, movies, and all the things on Emirates is amazing.  Being in coach feels like a luxurious experience.

But, I was brought out of my deep thoughts in the middle seat on aisle I-don't-recall far back in the plane by a flight attendant showing up to the left of my husband who was in the aisle seat saying they would like to upgrade us to Business Class and could we follow him.  So we grabbed our neck pillows and whatever was in our carry on's and walked toward the back of the plane AND UP A STAIRCASE (is this real life?!?) PASTA BAR WITH COUCHES TO THESE MASSIVELY SPACIOUS SEATS, THE KIND YOU CAN LIE DOWN IN!!

 All the stress of that flight was made worth it by the image I still have seared into my brain, his permasmile for the remainder of the flight.  Ladies and gentlewomen, this man had some fancy drinks, lounged on the couches, commented on the size of the windows and seeing the North Pole and the polar ice caps (for reals), watched movies, ate all the meals, stayed up for all the snacks bc who sleeps when you're living it large on our first and only since upgrade experience on the plane?!   I ate some delicious food I'm sure, but remained distracted, my mind on my patient and going downstairs and back to check on her over and over again, updating my notes.  

Don't serve the Doctor any alcohol, they said.  Don't worry, I'm not drinking on the job, wouldn't dream of it, hadn't even crossed my mind, plus I don't drink anyways.  But glad they're looking out hahaha.  

She had been sleeping, and I had to be the annoying Doctor who woke her up and made her drink some more. But thank God she was able to drink, she seemed to be holding things down.  She wasn't rapidly improving, but she wasn't deteriorating either.  And that was a win in my book.  She was remaining hydrated enough to replenish and her losses had slowed way down.  It had been hours since her last emesis.  

Suspended in my little metal medical clinic in the clouds (actually above WAY ABOVE) the clouds that day/night however many time zones we traversed in that metal bird over the polar ice caps and North Pole (Alohhhaaa Santa and Reindeer and elves, I'm sure they may have had a potential clinic if needed), it seemed an eternity before we started on final descent into Los Angeles.  

We landed.  She sat up and SHE WALKED OFF THE FLIGHT.  I provided a sign out and had the documentation necessary should she pursue further care and gave my best instructions to her family and airline personnel.  But again, she hadn't walked the entire flight at least that I saw, and SHE WALKED OFF THE FLIGHT.  Resilience.  Vulnerability. All of it.

HALLELUJAH! All the prayers, all the gratitude. It wasn't a matter of making the "right" or "wrong" decision or how great I was that day.... none of that mattered.  It was making an informed choice for my patient, and that's where my allegiance was. Of course I cared for the 300+ passengers and I'm sure we could have all toasted to Northern Russia and whatever adventure would have ensued being stranded together in the Russian tundra on a metal bird that landed and couldn't take off again.

But we hadn't landed.  Did I really just do that?!  I trusted deep within, tuned out the noise and pressures of other people, stayed true to myself and what I knew as a Physician, let my patient tell me all she could through her body and physical exam and what couldn't be exchanged verbally in words, synthesized this together, and went with my instinct.  

I'll praise God forever for that day and for that little girl showing her resiliency.  I've answered calls since then on planes (it happens to me a lot to the point where I now take inventory of my fellow passengers at the gate before boarding HAHAHAHAH), but nothing like that time.  The time where there was a little girl that needed me, in critical-is condition suspended 30,000+ feet off the ground with no medical access, and a potential landing strip in Northern Russia, and 300+ people being affected by my decision.  It was a FLIGHT.  A flight of epic proportions.  The mile high club, Doctor Edition had happened to me.  I'll never tire telling this story. 

And I still think of you brilliant little soul.  Thank you for teaching me so much that day. Thank you for being resilient.  And thank God for the things medicine can't measure- our intellect, experience, training, instinct, and intuition.  Because sometimes, that's the most important tool you have.  It happened to me.  I had to turn to my inner compass, speak from there and believe.  And then move into focused and loving action for the remaining 10 hours of that flight. 

The flight of Motherhood is much the same Mama.  At times you are faced with near-impossible decisions where the stakes seem so high and all eyes are upon you.  After all, YOU are the expert on your own child.  You feel like you're flying at 30,000+ feet without a care, feet up, watching a movie and you got this all relaxed, and then WHAM, a crisis hits and you're the only one who can respond.  

You do respond though.  Time and time again.  You come through with a solution, with a decision, with ideas and your innovation, your creativity.  You inner Artist synthesizes the information you have at hand and you weave together a most beautiful ongoing story.

So to all the Mamas who respond to medical emergencies big and small within your own homes and own little planes each and every day, I salute you.  I virtually upgrade you.  Can we all just picture ourselves in a Mama spa right now, some cucumbers over our eyes relaxing and savoring the sacred stratospheres of feeling supported and validated.  Because that is what envision for you, Mama.

To celebrate the big and little wins every day.  The solutions you are coming up with all throughout your day in the multiple roles you play.  

Here's to the Cruising Altitude of your Intuition.  Believe you're flying that plane, Mama.  And that even when the stakes feel high, and sometimes are, you have the solutions and the creativity, the Mamatuition and the Mamamentum within you to soar through and to emerge confidently in your skills to care and your compassion to heal.  You're magnificent.

Ladies and Gentlewomen, This is your captain speaking.  We are now beginning our initial descent.  Forecast calls for clear skies and warm temperatures.  But there could also be some turbulence ahead, nothing you haven't encountered before, though.

As we descend into the week ahead, now that you can always return flying in this space whenever you desire it.  Take the 30,000+ view of yourself for perspective from time to time, Mama.  You are truly a magnetic masterpiece of metallic shine gleaming in your glory.  I see you.

Soar on, Mama! It continues to be a pleasure flying in formation with you.

Oceans of Aloha + Polar Ice Caps,

- Anik